It is safer to ski today than in the past. Injury rates for skiers have decreased. Several factors, including improved ski slope management, grooming and safety and improved ski equipment and instruction, may account for the injury rate decline. Nevertheless, an estimated 15 million skiers are still injured and require treatment each year.
What to look for: Ski injuries are usually not life-threatening. Knee ligament sprains, thumb ligament injuries, contusions and lacerations are the most common. Victims are usually conscious. Nevertheless, cold and anxiety place the skier at risk of shock and hypothermia, so additional clothing should be put over and under the injured skier.Fractures. Broken bones account for about 10 percent of ski injuries. Clothing should not be removed to check the injury. Removing may increase the risk of hypothermia and shock.
While waiting for the ski patrol to arrive, lay the skier flat, covering (under and over) the skier with extra clothing to conserve body heat. Ski patrol members are trained professionals who stabilize injured skiers and are equipped to get them to medical professionals promptly.
If the ski patrol is unavailable, you should attempt to stabilize the fracture with a splint. A splint can be fashioned from any rigid material (tree branches, ski or ski pole) that can be secured to the leg with strips of fabric or clothing. For severely angulated limbs, apply traction and place the part in a more normal alignment. Transporting the victim is not possible without the ski patrol. It is best to stay with the victim until the patrol arrives.
Although open fractures are potentially both limb- and life-threatening, stabilization and transport is still what is most important while on the slope. Any skier who has lacerated skin under a fracture should be treated as if he or she has a open fracture. Apply a sterile or clean compression dressing and splint the limb.
Ligament injuries. Ligament injuries account for about 35 percent of ski injuries.
- Knee sprains. About 20 percent of the ski injuries requiring medical care are to the knee ligaments. The severe anterior cruciate ligament (ACL) sprain is becoming more frequent. ACL sprains are the only major skiing injury to increase significantly in the past 15 years. A medial collateral ligament (MCL) sprain, once the most common ligament injury in skiing, is becoming less frequent.
To stabilize a skier with a knee injury, treat for shock by removing the victim's skis, laying him or her flat, and make him or her comfortable. If the injury is very mild, have the victim do the following:
1. Straighten and bend the knee
2. Stand
3. Perform a knee bend
4. Pivot on the planted leg, first with the knee straight and then with it bent.
Only if the victim can perform all these maneuvers should he or she try to ski down the mountain. Otherwise, wait for the ski patrol.
- Thumb sprains. Thumb injuries account for about 10 percent of skier injuries. If reporting were improved, skier's thumb (sprained ligament) would probably be the most common ski injury.
Skier's thumb usually results when a skier lands on an outstretched arm while trying to break a fall. Injury occurs when the thumb is bent back. One study found that skiers using traditional grips without the straps had the lowest thumb injury rate.
The injured thumb can be stabilized against the palm of the hand using a bandanna, strip or clothing or tape. The skier's glove should be carefully placed over the entire hand to prevent frostbite. If the skier can grip the pole, he or she can carefully navigate to the bottom of the slope where medical attention can be acquired.
Though injury rates have fallen with advances in ski safety, the nature of skiing makes it unlikely that injuries will ever be eliminated from this exciting sport.
This is the second of a three-part series on ski injuries.